| NPI | 1639569395 |
|---|---|
| Former Name | KRISTIE ANN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical (Licence: HI 4806) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2022-03-17 |